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Mucociliary clearance in the lung is the primary defense mechanism that protects the airways from inhaled toxicants and infectious agents. The system consists of a viscoelastic mucus layer driven by motile cilia in a periciliary layer underneath the mucus layer. Under healthy conditions, the thickness of the periciliary layer is comparable to cilia length. Perturbations to this system, whether due to a genetic disorder or acquired causes, are directly linked to infection and disease. For example, depletion of the periciliary layer is typically observed in diseases such as chronic obstructive pulmonary disease and cystic fibrosis. Clinical evidence connects the periciliary layer depletion to reduced rates of mucus clearance. In this work, we develop a novel computational model to study mucociliary transport in a microfluidic channel consisting of a mucus layer (viscoelastic fluid) atop a periciliary layer (nearly-viscous fluid). We systematically vary the viscoelastic properties and thickness of the mucus layer to emulate healthy and diseased conditions. We assess cilia performance in terms of three metrics: flow transport, internal power expended by the cilia, and transport efficiency. We find that, compared to a control case with no mucus, a healthy mucus layer enhances cilia performance in all three metrics. That is to say, a healthy mucus layer not only improves flow transport, resulting in better clearance of harmful substances, but it does so at an energetic advantage to the cilia. In healthy states, an increase in the mucus elastic properties enhances transport efficiency. In contrast, under diseased conditions where the periciliary layer is depleted, mucus hinders transport... (trimmed by length restriction), Comment: 14 pages, 9 figures